- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $691.83 / $14,454.40
| Facility | | $436.52 | $691.83 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $18,197.01 / $29,512.09
| Facility | | $13,803.84 | $18,197.01 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $1,023.29 / $1,659.59
| Facility | | $891.25 | $1,023.29 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $7,413.10 / $14,454.40
| Facility | | $398.11 | $7,413.10 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $16,595.87 / $34,673.69
| Facility | | $389.05 | $16,595.87 | $34,673.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $575.44 / $831.76 / $1,445.44
| Professional | | $575.44 | $831.76 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51,286.14 / $51,286.14 / $75,857.76
| Facility | | $51,286.14 | $51,286.14 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $20,417.38 / $34,673.69
| Facility | | $8,709.64 | $20,417.38 | $34,673.69 |